Arm lymphedema in patients treated conservatively for breast cancer: relationship to patient age and axillary node dissection technique.
Identifieur interne : 009A78 ( Ncbi/Curation ); précédent : 009A77; suivant : 009A79Arm lymphedema in patients treated conservatively for breast cancer: relationship to patient age and axillary node dissection technique.
Auteurs : R D Pezner ; M P Patterson ; L R Hill ; J A Lipsett ; K R Desai ; N. Vora ; J Y Wong ; K H LukSource :
- International journal of radiation oncology, biology, physics [ 0360-3016 ] ; 1986.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- complications : Surgical Wound Infection.
- etiology : Lymphedema.
- methods : Lymph Node Excision.
- surgery : Pectoralis Muscles.
- therapy : Breast Neoplasms.
- Adult, Age Factors, Aged, Arm, Axilla, Female, Humans, Lymphatic Metastasis, Middle Aged.
Abstract
Arm lymphedema (ALE) was evaluated in 74 patients treated conservatively for breast cancer. ALE was defined based upon measurements performed upon 35 volunteer subjects who did not have and were never treated for breast cancer. Multiple variable statistical analysis of 74 breast cancer patients revealed that age at diagnosis was the most important factor related to the subsequent development of ALE. ALE appeared in 7 of 28 patients (25%) 60 years of age or older but in only 3 of 46 (7%) younger patients (p less than 0.02). Axillary node dissection (AND) was the only other statistically significant factor. For the younger patients, obesity and post-operative wound complications appeared to be contributing factors. For the older patients, AND technique was the only significant factor. ALE developed in only 1 of 10 (10%) of the older patients who underwent AND without splitting the pectoralis minor muscle (PMM), but in 6 of 11 (55%) who underwent AND with PMM split (p less than 0.03). Splitting the PMM during AND did not yield more lymph nodes for pathological analysis nor did it yield a higher incidence of patients with nodal metastases. Neither the use of lymph node radiation therapy fields, radiation to the full axilla, nor systemic chemotherapy was associated with ALE. We conclude that older patients are at higher risk of ALE and that this complication can possibly be reduced by not splitting the PMM during axillary node dissection.
PubMed: 3793544
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Vora</name></author><author><name sortKey="Wong, J Y" sort="Wong, J Y" uniqKey="Wong J" first="J Y" last="Wong">J Y Wong</name></author><author><name sortKey="Luk, K H" sort="Luk, K H" uniqKey="Luk K" first="K H" last="Luk">K H Luk</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1986">1986</date><idno type="RBID">pubmed:3793544</idno><idno type="pmid">3793544</idno><idno type="wicri:Area/PubMed/Corpus">006493</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">006493</idno><idno type="wicri:Area/PubMed/Curation">006493</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">006493</idno><idno type="wicri:Area/PubMed/Checkpoint">006493</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">006493</idno><idno type="wicri:Area/Ncbi/Merge">009A78</idno><idno type="wicri:Area/Ncbi/Curation">009A78</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Arm lymphedema in patients treated conservatively for breast cancer: relationship to patient age and axillary node dissection technique.</title><author><name sortKey="Pezner, R D" sort="Pezner, R D" uniqKey="Pezner R" first="R D" last="Pezner">R D Pezner</name></author><author><name sortKey="Patterson, M P" sort="Patterson, M P" uniqKey="Patterson M" first="M P" last="Patterson">M P Patterson</name></author><author><name sortKey="Hill, L R" sort="Hill, L R" uniqKey="Hill L" first="L R" last="Hill">L R Hill</name></author><author><name sortKey="Lipsett, J A" sort="Lipsett, J A" uniqKey="Lipsett J" first="J A" last="Lipsett">J A Lipsett</name></author><author><name sortKey="Desai, K R" sort="Desai, K R" uniqKey="Desai K" first="K R" last="Desai">K R Desai</name></author><author><name sortKey="Vora, N" sort="Vora, N" uniqKey="Vora N" first="N" last="Vora">N. Vora</name></author><author><name sortKey="Wong, J Y" sort="Wong, J Y" uniqKey="Wong J" first="J Y" last="Wong">J Y Wong</name></author><author><name sortKey="Luk, K H" sort="Luk, K H" uniqKey="Luk K" first="K H" last="Luk">K H Luk</name></author></analytic><series><title level="j">International journal of radiation oncology, biology, physics</title><idno type="ISSN">0360-3016</idno><imprint><date when="1986" type="published">1986</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Age Factors</term><term>Aged</term><term>Arm</term><term>Axilla</term><term>Breast Neoplasms (therapy)</term><term>Female</term><term>Humans</term><term>Lymph Node Excision (methods)</term><term>Lymphatic Metastasis</term><term>Lymphedema (etiology)</term><term>Middle Aged</term><term>Pectoralis Muscles (surgery)</term><term>Surgical Wound Infection (complications)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Bras</term><term>Facteurs de l'âge</term><term>Femelle</term><term>Humains</term><term>Infection de plaie opératoire ()</term><term>Lymphadénectomie ()</term><term>Lymphoedème (étiologie)</term><term>Muscles pectoraux ()</term><term>Métastase lymphatique</term><term>Sujet âgé</term><term>Tumeurs du sein ()</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Surgical Wound Infection</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Pectoralis Muscles</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Age Factors</term><term>Aged</term><term>Arm</term><term>Axilla</term><term>Female</term><term>Humans</term><term>Lymphatic Metastasis</term><term>Middle Aged</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Bras</term><term>Facteurs de l'âge</term><term>Femelle</term><term>Humains</term><term>Infection de plaie opératoire</term><term>Lymphadénectomie</term><term>Muscles pectoraux</term><term>Métastase lymphatique</term><term>Sujet âgé</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Arm lymphedema (ALE) was evaluated in 74 patients treated conservatively for breast cancer. ALE was defined based upon measurements performed upon 35 volunteer subjects who did not have and were never treated for breast cancer. Multiple variable statistical analysis of 74 breast cancer patients revealed that age at diagnosis was the most important factor related to the subsequent development of ALE. ALE appeared in 7 of 28 patients (25%) 60 years of age or older but in only 3 of 46 (7%) younger patients (p less than 0.02). Axillary node dissection (AND) was the only other statistically significant factor. For the younger patients, obesity and post-operative wound complications appeared to be contributing factors. For the older patients, AND technique was the only significant factor. ALE developed in only 1 of 10 (10%) of the older patients who underwent AND without splitting the pectoralis minor muscle (PMM), but in 6 of 11 (55%) who underwent AND with PMM split (p less than 0.03). Splitting the PMM during AND did not yield more lymph nodes for pathological analysis nor did it yield a higher incidence of patients with nodal metastases. Neither the use of lymph node radiation therapy fields, radiation to the full axilla, nor systemic chemotherapy was associated with ALE. We conclude that older patients are at higher risk of ALE and that this complication can possibly be reduced by not splitting the PMM during axillary node dissection.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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